|Petrozavodsk State University, 185910 Russia, Petrozavodsk, Lenin str., 33, firstname.lastname@example.org|
|Petrozavodsk State University, 185910 Russia, Petrozavodsk, Lenin str., 33, NALarina@inbox.ru|
|Petrozavodsk State University, 185910 Russia, Petrozavodsk, Lenin str., 33, email@example.com|
nonalcoholic fatty liver disease
tumor necrosis factor alpha
The influence of gender on the course of non-alcoholic fatty disease (NAFLD) is not clear so far. Opinions of researchers on this issue are controversial. The aim of our study was to evaluate the impact of gender on the structure and clinical features of NAFLD. Materials and methods. The study involved 286 patients with NAFLD: 169 (59.1%) men and 117 (40.9%) women. The diagnosis of NAFLD was based on clinical, laboratory, sonographic data and results of a liver biopsy. Tumor necrosis factor-α (TNF- α) was determined in 85 (29.7%) patients by ELISA. NAFLD fibrosis score (NFS) was calculated. Results. Hepatic steatosis (HS) was diagnosed in 126 (44.1%) patients and steatohepatitis (SH) in 160 (55.9%). In the group of patients with HS, the number of men was 1.5 times higher than that of women, and they were, on average, 7 years younger than women. Levels of alanine aminotransferase (ALAT), triglycerides (TG), and TNF-α were significantly higher in men than in women: 18.2±7.8 U/l, 3.41±2.1 mmol/l, 5.57±0.5 pg/ml vs. 11.3±4.0 U/l, 1.76±0.2 mmol/l, 4.67±0.4 pg/ml, respectively, and, on the contrary, the level of high-density lipoproteins was lower: 0.96±0.24 mmol/l vs. 1.53±0.53 mmol/l (p<0.05). SH, as well as HS, developed in men 7 years earlier than in women. The levels of ALAT and TNF-α were significantly higher in men than in women: 62.70±20.47 U/l, 6.10±1.1 pg/ml vs. 40.59±21.39 U/l and 5.19±1.12 pg/ml, respectively. Men suffering from SH had significantly higher level of serum iron and ferritin than women: 32.6±2.7 mkmol/l, 233.7±52.4 mkg/l vs. 17.3±3.2 mkmol/l, 73.5±29.8 mkg/l, respectively. NFS was higher in men than in women: (-0.156±0.336) vs. (-0.250±0.370) (p>0.05). Conclusions. 1) SH prevailed over HS, both in men and in women, in the structure of NAFLD; liver cirrhosis was not detected. 2) NAFLD occurred 7 years earlier in men than in women. 3) Markers of hepatocellular inflammation, dyslipidemia, ferremia, and fibrosis were more expressed in men than in women. 4) These facts indicated a more aggressive course of NAFLD in men than in women.